Tallahassee Orthopaedic Clinic Founding Members Tom C. Haney, MD (left) and William D. Henderson, Jr., MD (right).
Courtesy of TOC


Published 7/1/2009
Nick Piatek

Making advocacy a priority—and supporting it painless

Tallahassee group develops political contribution model

Plenty of orthopaedic groups have 100 percent participation in complaining about high medical liability premiums, unfunded mandates, and other legislative actions that affect their practices. But few match the 100 percent participation by the Tallahassee Orthopedic Clinic (TOC) in helping to bring about positive changes by getting involved in the political process.

“When I moved to Tallahassee 7 years ago, I saw my medical liability insurance premiums go up 400 percent. That is not right, and I came to the realization that we had to do something,” said TOC partner Andrew H. Borom, MD.

It took some time, but 4 years ago, the group developed a political contribution model that recognizes the importance of participating in advocacy efforts, makes it easy for partners to contribute, and encourages consistent contributions to support political action committees (PACs), legislative campaigns, and other advocacy activities.

Putting advocacy first
Under the model developed by the group, each TOC physician opens an individual checking account labeled “Discretionary Account.” Every month, a minimum of $200 is automatically deposited into the account. In accordance with campaign finance laws, the political contributions are not mandated and the money is placed into the accounts after going through appropriate payroll accounting.

Under this model, each physician has at least $2,400 a year to devote to political action committees (PACs) and other political contributions. Contributions are split four ways for partners who contribute the minimum amount: $500 goes to the Orthopaedic PAC of the American Association of Orthopaedic Surgeons, $250 to the Florida Orthopaedic PAC, $400 to the Florida Medical Association PAC, and $1,250 is left for the individual to contribute in whatever way he or she wishes.

The checkbooks for the accounts are kept under lock and key at the office; a physician can easily access his or her checkbook to make political contributions. Mark E. Fahey, MD, TOC partner and former President of the Florida Orthopaedic Society, notes that several TOC doctors give more than the $200 monthly minimum.

Responding to the need
“People kept saying that they didn’t have their checkbooks on them so we came up with this model,” Dr. Fahey said. The TOC approach enables its doctors to remain active in advocacy with a minimal time commitment.

The automatic deposit has another advantage, according to Dr. Borom. “Because the money never enters your wallet, you never have to feel the sting of removing it.”

Since implementing this model, the TOC has a 100 percent participation rate among its 20 doctors, who can see the difference getting involved can make.

“We were always finding out about things that the state and federal legislature were doing after the fact,” said Dr. Fahey. “We had to get involved in the process. Now, we can see the number of successful races that we have supported. Even if we lose some of the individual battles, we still come away with measurable involvement in the process.”

“A cost of doing business”
By addressing the partners’ desires to be politically active with a painless, convenient process, the TOC has created a model that it hopes other groups will implement.

“Wherever I go, I spend a lot of time trying to spread the word about this model. If we can get every doctor in America to invest $2,400 a year in advocacy efforts, we would have an enormous opportunity to influence legislation that affects us all,” Dr. Borom said.

To implement such a model, the TOC stresses that doctors must treat making PAC and other political contributions as a necessity.

“This must be considered a cost of doing business. Someone out there is always looking to interfere with your practice, cut your reimbursement, raise your liability exposure, or interpose themselves in the doctor-patient relationship. The only way to stop this and ensure that we can care for our patients is to have a receptive legislature on our side. The only way to accomplish that is to get in the game,” Dr. Borom said.

“The AAOS and specialty orthopaedic organizations can play a crucial advocacy role,” agreed Peter J. Mandell, MD, chair of the AAOS Advocacy Council. “But the actions of individual, practicing orthopaedic surgeons are also critical in advancing the legislative agenda of the orthopaedic community.”

To find out more about the Orthopaedic PAC, visit www.aaos.org/pac or call the AAOS office of government relations at (202) 546-4430. To learn more about the TOC model, contact Martin Shipman, chief executive officer at the TOC, at martin.shipman@tlhoc.com

Nick Piatek is the communications specialist in the AAOS office of government relations. He can be reached at piatek@aaos.org